Inside the Testing Shortage: Why So Many Doctors Can’t Test Their Patients

The United States is currently running around 150,000 coronavirus tests a day, but health officials believe the country will need to perform around 2 million tests a day if we are going to be able to safely reopen the economy completely and send millions of people back to work.

Testing and contact tracing are crucial when it comes to preventing future outbreaks. Providers will need to test people for the virus at the door before they come back to work, get on a plane, or bring their child to school. If someone tests positive, contact tracers will need to reach out to everyone that has been near this person and ask them to self-quarantine.

Yet, thousands of patients say they still cannot get tested for the virus, and providers aren’t sure what to tell their patients. If you are having trouble getting tests or getting tested for the virus, find out why.

The View from the Top

President Trump has been promising an increase in the country’s testing capacity for weeks. Back in March, he talked about turning commercial parking lots into drive-thru testing centers, yet only a handful of sites were ever operational. He has also said that every American can get tested if they so choose, but that isn’t exactly true.

Yesterday during a congressional hearing with the White House Coronavirus Task Force, health officials decried a lack of coronavirus testing supplies. In response, the president says he is working on getting more supplies to states, so they can ramp up their testing operations as quickly as possible.

Numerous state governors, including those from Kansas, California, Michigan, and New York, have been calling on the president to send more tests, but even when more tests arrive, providers are having trouble utilizing them on the job.

But why?

Testing patients for the coronavirus is more complicated than most of us may realize. To determine whether a patient has an active COVID-19 infection, several steps must be taken:

  • Step One:

The nurse or doctor will swap the patient’s nose or throat to collect a sample. They will then house the sample in a chemical solution to preserve the genetic material.

  • Step Two:

The nurse sends the sample off to a lab. The lab technician will then extract the genetic material from the sample using a special machine and chemicals known as reagents.

  • Step Three:

The technician will then put the genetic material into another machine, which will check the sample for traces of the coronavirus. If the test comes back positive, that person has the virus.

As you can see, testing involves a range of moving parts and highly specialized medical equipment.

What’s the Problem?

Medical facilities and testing labs across the country say they have the equipment to ramp up testing, but providers often lack the supplies needed to administer these tests effectively. In order to run a test, all parts of the supply chain must align. For example, a doctor’s office may have all the supplies it needs to run these tests, but the lab it uses to process them may be out of special equipment.

Here are some of the biggest problems with testing:

  • Testing Swabs

The country is in the middle of a severe shortage of testing swabs, among other equipment. As you probably already know, these aren’t the cotton swabs you buy at a local drugstore. They are considered medical devices, and they have to be long and flexible enough to gather genetic material from the patient’s nose or throat.

Providers can’t use standard cotton swabs, or it may jeopardize the test results. Cotton contains its own genetic material, so it’s best to use swabs made from synthetic materials like polyester.

When the pandemic began earlier this year, there were only two companies in the world that produced these swabs, including Puritan Medical Products in Maine and Copan Diagnostics in Italy. The virus led to a surge in demand for testing swabs, and these companies couldn’t keep up. Health officials and state governors have urged the president to invoke the Federal Defense Production Act to compel private companies to manufacture testing swabs, but this plan has yet to move forward.

  • PPE

Providers also need access to personal protective equipment in order to test their patients for the virus. Collecting samples from the patient requires close contact, so providers need to wear face masks, gloves, and hazmat suits when swabbing their patients.

  • Reagents

Manufacturers are struggling to ramp up production of the reagents used in the testing process. These chemicals are considered extremely sensitive and difficult to produce. Companies typically produce reagents in small batches, but the virus has led to a surge in demand. However, these companies are hesitant to ramp up production and alter their operations if this surge in demand is only temporary. Producing large volumes of reagents also makes it difficult to maintain quality assurance.

  • Testing Capacity

We often hear plenty of talk about “testing capacity,” but it’s not the same as actual testing. Testing capacity refers to the number of tests states and the country can perform on a regular basis. Even if a state has a high testing capacity, it doesn’t mean they are testing as many patients as they should be.

One of the main challenges in ramping up testing is estimating how many tests the U.S. will actually need months or even years down the line. Health officials must agree on a specific testing capacity goal, so everyone can work together.

Are More Tests on the Way?

The federal government is currently weighing whether to invoke the Defense Production Act to create more tests. President Trump recently said that Puritan Medical Products has been awarded a $75 million dollar contract to increase swab production. However, the government wants to focus on high-risk communities, such as nursing homes, to receive these testing supplies as a priority.

The FDA recently approved several new types of coronavirus tests that do not require a swab, thus easing demand on swab production and potentially ramping up testing capability.

Hopefully, we will reach our goal of performing 2 million tests a day, but until that happens, many providers and patients continue in frustration at the lack of available testing.

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